1. Front
Our Logo – Lollicup Fresh
How did we do today?
We value your comments about your experience at Lollicup Fresh. Please help us improve by taking a few moments to complete this short survey. We will give you a Free 16oz drink*!
Store Visited:
□ Brea □ Diamond Plaza □ Riverside □ West LA
Time of visit
_____/ _____/______ (mm/dd/yy) ________________(am/pm)
Please indicate your age range:
□18 or below □ □ □40 or above
Join our FiveStars rewards program and you’ll be the first to know about special promotions and events.
Name: (first)_________________(last)_________________
Cell :(_________)_________________________
Date of Birth: ______mm ______dd
(we will not share customer information)
Stay connected with us:
Website | Facebook | Twitter | Instagram | Yelp
*Please continue on the back of this survey

2. Back 1.How did you hear about us?
□Word of mouth □Walk-in □Social Media (eg: Facebook/Twitter)
□Magazine/Newspaper □ Friends/Family members Other: _________
2. How often do you visit us?
□This is my first time □Once a week □More than once a week
□Bi-weekly □About once a month Other: ________________
3. How would you rate your customer service satisfaction with us?
□Excellent □ Satisfactory □Fair □Poor Other: _______________
4. How would you rate the overall taste and flavor of the drinks?
□Excellent □ Satisfactory □Fair □Poor Other:________________
5. How would you rate the overall taste and flavor of the food?
6. How would you rate the wait time for picking up your order?
□Very fast □ Reasonable □Slow □ Unacceptable
Other: ____________
7. How would you rate the atmosphere (music, décor, cleanliness, etc.)?
□Excellent □Satisfactory □Fair □Poor Other _____________
8. What is (are) the most important factors that made you choose to visit?
□Quick service □Quality of drink or food
□Price / Promotion □Friendly staff Other:_______________
Anything else that you would like to share with us?
__________________________________________________________
We appreciate you taking the time to complete this survey.
Please submit to our staff and receive one 16oz drink* on us!
( * free drink includes black tea, green tea, milk tea, jasmine green milk tea or Thai tea)
Thank you for your time and feedback!